Why it's done

Thirty to 40 percent of people with epilepsy don't fully respond to anti-seizure drugs. Vagus nerve stimulation may be an option to reduce the frequency of seizures in people who haven't achieved control with medications.

Vagus nerve stimulation may also be helpful for people who haven't responded to intensive depression treatments, such as antidepressant medications, psychological counseling (psychotherapy) and electroconvulsive therapy (ECT).

The Food and Drug Administration (FDA) has approved vagus nerve stimulation for people who:

  • Are 12 years old and older
  • Have focal (partial) epilepsy
  • Have seizures that aren't well-controlled with medications

In addition, the FDA has approved vagus nerve stimulation for the treatment of depression in adults who:

  • Have chronic, hard-to-treat depression (treatment-resistant depression)
  • Haven't improved after trying four or more medications or electroconvulsive therapy (ECT), or both
  • Continue standard depression treatments along with vagus nerve stimulation
Dec. 24, 2015
References
  1. Beekwilder JP, et al. Overview of the clinical applications of vagus nerve stimulation. Journal of Clinical Neurophysiology. 2010;27:130.
  2. Morris, GL, et al. Evidence-based guideline update: Vagus nerve stimulation for the treatment of epilepsy: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013; 81:1453. http://www.neurology.org/content/81/16/1453.short.
  3. Chengyuan Wu, et al. Neurostimulation for the treatment of epilepsy: A review of current surgical interventions. Neuromodulation. 2013;16:10.
  4. VNS therapy system — P970003s050. U.S. Food and Drug Administration. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm078532.htm. Accessed Nov. 3, 2015.
  5. Vagus nerve stimulation. American Association of Neurosurgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Vagus%20Nerve%20Stimulation.aspx. Accessed Sept. 3, 2015.
  6. Martin JLR, et al. Systematic review and meta-analysis of vagus nerve stimulation in the treatment of depression: Variable results based on study designs. European Psychiatry. 2012;27:147.
  7. Britton JW (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2015.
  8. Seizures and epilepsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/epilepsy/detail_epilepsy.htm. Accessed Sept. 25, 2014.
  9. Karceski, S., et al. Vagus nerve stimulation for the treatment of epilepsy. http://www.uptodate.com/home. Accessed Nov. 3, 2015.
  10. Holtzheimer, PE, et al. Unipolar depression in adults: Treatment with surgical approaches. http://www.uptodate.com/home. Accessed Nov. 3, 2015.
  11. Yuan, H, et al. Vagus nerve and vagus nerve stimulation, a comprehensive review: Part II. Headache. In press. Accessed Nov. 3, 2015.